Case:Poji
Poji was deceptively easy to manage/regulate/lead into remission. He accepted the switch from dry to high quality low-carb canned food without complaint, sat compliantly for BG testing, did not require any substantial settling time for a given insulin dose and responded in a mathematically predictable way to the Humulin U, which allowed me to change dosing on the fly based on his PS values and keep him in a good range the majority of the time. That said, I shudder to think what wouldn't happened if I hadn't been hometesting. The timeline went roughly: Sometime in 2002: Old vet says "Your cat is fat, he's going to get diabetes. He needs to lose weight. Use weight control catfood." We switch to Iams Weight Control Dry, a terribly species-inappropriate diet at 43% of calories from carbohydrates. Big mistake, as we find out years later when... 10/7/05 - Poji is losing weight, drinking too much, typical symptoms, so into the vet we go. Tentatively diagnosed, bloodwork sent off. Begin switching to canned food but no insulin yet. In-office meter reads 376. 10/10/05 - Official DX- labwork indicates BG level of 482. We decide to give him a week on the lower carb food to see if he responds. 10/15/05 - In office meter: 340. Began 2u BID of Humulin U. PS values in the 300s at home. Poji spends the first day flat but then begins to respond well to the insulin. 10/18/05 - PS 350, 2u. Near-hypo, 56 at +4. Dose reduced to 1u BID. Confirmed at vet visit the next day, he now reads 270 at home and on the lab's meter, 170 on the in office meter. They tell me to reduce to 1u; already have. 10/23/05 - PS values now always below 250, occassionally in the 100s. Dose reduced to 0.5u-0.75u. I decide at this point to only shoot if the PS is 200 or higher. I will be glad that I stick to my guns on this one. 10/25/05 - PS 237, 0.75u, Symptomless hypo(38 at +4). Around this time he was barely ever high enough in the morning to shoot(160s mostly) and we were going SID despite my best efforts otherwise. 10/27/05 - He finally creeped to 200 and I gave him 0.25u, the smallest dose I could 'eyeball'. He dropped to 65 in two hours. He never again has hit 200 and has not had an insulin shot since, spending most of his time in the high double-digits and low 100s. I feel that remission was acheived partially because Poji was unusually insulin-responsive which allowed us to nail down effective dosing with minimal guesswork, partially due to diet change, and partially due to the close monitoring that allowed us to treat in a way that was both aggressive enough to give his pancreas a rest and accommodating of his rapidly decreasing insulin needs. Poji is now currently symptomless, free of any other diseases or complications, and has a very high quality of life. He eats Wellness Beef & Chicken canned food, 9oz/day, in four feedings. His highest spotchecks are usually in the mornings right before eating. Update: During a recent sequence of unfortunate stressors(a stay in vet boarding, dental issues, a nasty bladder infection that took several weeks to put to rest), Poji was once again needing insulin and was, by our definition, unregulated - Preshot readings typically in the mid to high 300s. However, with the resolution of these issues he has fallen into tight regulation and is typically between 50 and 170 on any given insulin cycle. We have hopes of him returning to remission if kept in a normal range for long enough. Further Reading More at His FDMB profile Category:Feline cases Category:Humulin U cases Category:low-carb cases Category:Male cases Category:Regulated cases Category:Remission cases Category:Tight Regulation cases Category:Feline male cases Category:Feline regulated cases Category:Feline tight regulation cases Category:Feline low-carb cases